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Rhinoplasty
Rhinoplasty commonly known as a nose job, is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the nose by resolving nasal trauma (blunt, penetrating, blast), congenital defect, respiratory impediment, or a failed primary rhinoplasty. In the surgeries—closed rhinoplasty and open rhinoplasty—an otolaryngologist (ear, nose, and throat specialist), a maxillofacial surgeon (jaw, face, and neck specialist), or a plastic surgeon creates a functional, aesthetic, and facially proportionate nose by separating the nasal skin and the soft tissues from the osseo-cartilaginous nasal framework, correcting them as required for form and function, suturing the incisions, and applying either a package or a stent, or both, to immobilize the corrected nose to ensure the proper healing of the surgical incision.
Preparation for surgery:
The surgery can be carried out by a plastic surgeon who is experienced in such cases or by an expert ear nose throat surgeon.
It is an outpatient procedure done under local anaesthesia and the patient can go home the same day. Sometimes it can also be done under general anaesthesia. In case there are other corrections to be performed along with the nose job, patient may have to stay one night in the hospital after the surgery.
A thorough medical and psychological assessment of the patient is done before declaring him or her fit for surgery. Realistic expectations in terms of look of the face and nose are explained to the patient to avoid any postoperative depression.
Procedure:
During rhinoplasty, the surgeon makes incisions to access the bones and cartilage that support the nose. The incisions are usually made inside the nose(closed rhinoplasty) so that they are invisible after the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may be added (either from another part of the body or using a synthetic filler). After the surgeon has rearranged and reshaped the bone and cartilage, the skin and tissue is re-draped over the structure of the nose. A splint is placed outside the nose to support the new shape of the nose as it heals. At times the incision can be made on the under-side of the nose (on the narrow strip of tissue that separates the nostrils), and is known as open rhinoplasty. The incision is not visible.
An overly large nose may be reduced by removing bone or cartilage. Sometimes surgery of the nose may require the addition of cartilage grafts.
Most commonly, cartilage from the septum, the partition in the middle of the nose, is used for this purpose. Occasionally cartilage from the ear or rarely a section of rib cartilage can be used.
If the nasal septum is deviated, it can be straightened and the projections inside the nose reduced to improve breathing.
Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is re-draped and incisions are closed.Additional incisions may be placed in the natural creases of the nostrils to alter their size.
Recovery Period:
After the surgery the nose and surrounding area will be in splint and bandaged.
The areas around the nose will appear bruised and swollen for a couple of weeks. The patient will be advised to apply cold compresses over the area. In case the pain is more, pain killers will be administered. The patient is refrained from lifting heavy weight and doing strenuous activity for a couple of weeks. He should sleep with his head raised.
Healing is a slow and gradual process. The tip of the nose may have some swelling and numbness for months. You may not be able to see the final results for up to a year.
The non-surgical rhinoplasty procedure corrects and modifies slight defects of the nose by means of subcutaneous injections of biologically inert fillers; the results tend to be relatively transitory, in comparison with the results of nose surgery.
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